ORIGINAL COMMUNICATION

Journal of Neurology

, Volume 253, Issue 9, pp 1197-1202

First online:

Dural sinus thrombosis in spontaneous intracranial hypotension

Hypotheses on possible mechanisms
  • Mario SavoiardoAffiliated withDepartment of Neuroradiology, Istituto Nazionale Neurologico “C. Besta”
  • , Silvia ArmeniseAffiliated withDepartment of Radiology, Card. G. Panico Hospital
  • , Pantaleo SpagnoloAffiliated withDepartment of Radiology, F. Ferrari Hospital
  • , Tiziana De SimoneAffiliated withDepartment of Neuroradiology, Istituto Nazionale Neurologico “C. Besta”
  • , Maria Luisa MandelliAffiliated withDepartment of Neuroradiology, Istituto Nazionale Neurologico “C. Besta”
  • , Alessandra MarconeAffiliated withDepartment of Neurology, San Raffaele Hospital
  • , Giancarlo MorcianoAffiliated withDepartment of Radiology, F. Ferrari Hospital
  • , Cosma AndreulaAffiliated withDepartment of Neuroradiology, Città di Lecce
  • , Eliana MeaAffiliated withDepartment of Neurology, Istituto Nazionale Neurologico “C. Besta”
    • , Massimo LeoneAffiliated withDepartment of Neurology, Istituto Nazionale Neurologico “C. Besta”
    • , Luisa ChiappariniAffiliated withDepartment of Neuroradiology, Istituto Nazionale Neurologico “C. Besta” Email author 

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Abstract

Dural sinus thrombosis (DST) is rarely associated with spontaneous intracranial hypotension (SIH). Engorgement of the venous system, caused by the CSF loss that occurs in SIH, is considered to favour the thrombosis, although signs of both SIH and DST are usually seen simultaneously at the first diagnostic MRI. We observed two patients with SIH and DST. Changes in pattern of headaches and MRI findings demonstrated that DST followed SIH. In SIH, the velocity of the blood flow in the dural sinuses may be reduced because of dilatation of the venous system which compensates the CSF loss. Other possible mechanisms seem unlikely on the grounds of both clinical presentation and MRI studies.

Keywords

spontaneous intracranial hypotension CSF loss dural sinus thrombosis venous hypervolemia blood flow velocity